糖皮质激素联合丙种球蛋白治疗紫癜性肾炎患儿的临床效果及对相关指标的影响  

Clinical effect of glucocorticoid combined with gamma globulin in the treatment of children with Henoch-Schonlein purpura nephritis and its influence on related indexes

作　　者：刘晶 江晓丽 LIU Jing;JIANG Xiaoli(Changsha Health Vocational College,Hunan Province,Changsha 410006,China)

机构地区：[1]长沙卫生职业学院,长沙市410006

出　　处：《临床合理用药杂志》2021年第29期16-18,共3页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察糖皮质激素联合丙种球蛋白治疗儿童紫癜性肾炎的临床效果及对相关指标的影响。方法选取2017年6月-2020年5月长沙市第四医院儿科收治的紫癜性肾炎患儿62例,采用随机数字表法分为观察组和对照组,每组31例。对照组予以常规治疗加用糖皮质激素,观察组则在对照组治疗基础上加用丙种球蛋白。比较2组患儿临床疗效,治疗前后免疫功能指标[免疫球蛋白A(Ig A)、免疫球蛋白M(Ig M)、免疫球蛋白G(Ig G)]、炎性介质指标[白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)]变化情况,以及不良反应发生情况。结果观察组治疗总有效率为100.00%,高于对照组的83.87%(χ^(2)=5.439,P=0.02)。与治疗前比较,治疗后观察组Ig A水平显著降低(P<0.01),且观察组治疗后Ig A水平低于对照组(t=2.342,P<0.05);与治疗前比较,2组患儿治疗后Ig G水平均显著降低(P<0.01),但2组间比较差异无统计学意义(P>0.05);2组患儿Ig M水平治疗前后均无明显改善,差异无统计学意义(P>0.05)。与治疗前比较,2组IL-1β、TNF-α水平均明显降低,且观察组低于对照组(t=3.855、4.741,P均<0.01)。2组患儿不良反应总发生率比较差异无统计学意义(χ^(2)=0.161,P=0.92)。结论糖皮质激素联合丙种球蛋白治疗紫癜性肾炎患儿的临床效果显著,安全可靠,值得在临床工作中推广应用。Objective To observe the clinical effect of glucocorticoid combined with gamma globulin in the treatment of children with Henoch-Schonlein purpura nephritis.Methods From June 2017 to May 2020,62 children with purpuric nephritis admitted to the Department of Pediatrics of Changsha Fourth Hospital were selected,and the patients were divided into observation group and control group with 31 cases each by random number table.The control group was given conventional treatment plus glucocorticoids,and the observation group was given gamma globulin on the basis of the control group treatment.The clinical efficacy,immune function,inflammatory mediators,and adverse reactions of the two groups before and after treatment were compared.Results The total effective rate of treatment in the observation group was 100.00%,which was higher than 83.87%in the control group(χ^(2)=5.439,P=0.02).Compared with before treatment,the IgA level of the observation group was significantly reduced after treatment(P<0.01),and the IgA level of the observation group after treatment was lower than that of the control group(t=2.342,P<0.05).The IgG levels of the two groups of children after treatment were significantly lower than before treatment(P<0.01),but there was no significant difference between the two groups(P>0.05).There was no significant improvement in IgM levels of the two groups of children before and after treatment,and the difference was not statistically significant(P>0.05).The levels of IL-ip and TNF-a in the two groups were significantly lower than before treatment,and the observation group was lower than the control group(χ^(2)=3.855、4.741,P all<0.01).There was no significant difference in the total incidence of adverse reactions between the two groups(χ^(2)=0.161,P=0•92).Conclusion Glucocorticoid combined with gamma globulin is effective in treating children with Henoch-Schonlein purpura nephritis,safe and reliable,and is worthy of clinical application.

关 键 词：紫癜性肾炎 儿童 丙种球蛋白 糖皮质激素 临床疗效 

分 类 号：R726.9[医药卫生—儿科]